NPIMap

Individual provider Active NPI

Roger Edward Mendis, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1861493413
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G83502 Issued in CA
Practice address
2725 Capitol Ave
Suite 300
Sacramento, CA 95816-6004
Phone
(916) 262-9370
Fax
(718) 262-9375
NPI assigned
Aug 4, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 164935 NY
Gastroenterology Physician 207RG0100X G83502 CA Primary

Addresses

Primary practice location

2725 Capitol Ave
Suite 300
Sacramento, CA 95816-6004

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
01423138MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000404 CA Practitioner - Gastroenterology 3476512229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Tufts University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

Hospital & facility affiliations

  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy155
Upper gastrointestinal (GI) endoscopy for acid reflux114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83502CAMDPharmacist
G83502CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 15, 2007 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 15, 2007 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Booth Medical Associates PC Gastroenterology Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2801 K St
Ste 502
Sacramento, CA 95816
Phone (877) 515-0053

2725 Capitol Ave
Dept 300
Sacramento, CA 95816
Phone (916) 262-9370

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

Interoperability endpoints

  • Direct secure messaging: rmendismd38876@hisp.ehr.sutterhealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1861493413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CAPITOL AVE",
            "address_2": "SUITE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166004",
            "telephone_number": "916-262-9370",
            "fax_number": "718-262-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIS",
        "first_name": "ROGER",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2015-07-28",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "164935",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G83502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01423138",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.